Question

32. What are the other disorders on the spectrum and describe them. 33. Is autism cause by parental neglect? 34. Is there scientific evidence to support the theory that autism is caused by immunization? 35. What treatment is available?

Answer 1

32.Dr. Leo Kanner (1943) was the first person to describe about autism. Autism Spectrum Disorder (ASD) refer to a group of developmental disorders that affect brain development in the early childhood. It is used in synonymous with Pervasive Developmental Disorder (PDD). Autism is considered to be the second most developmental disorder of childhood in United States. There will be marked deficits in social interaction and communication in children with these disorders. The disorders in these spectrum are:

Autistic Disorder

This is characterized by deficits in three major areas of development: socialization, communication and presence of repetitive behaviours. Some children have sensory issues and issues related to sleeping and eating patterns. Temper tantrums, learning disorders, phobias and aggression may also be present. Individual differences are observed among people with autism. delayed language development is a significant symptom in autistic disorder.

Asperger's Disorder

This disorder is characterized by deficits in social interaction and repetitive behaviours. Children with Asperger's disorder have normal intelligence. Deficits in communication and cognitive capacity are not generally present in such children. They have deficits in adaptive functioning and forming social relationships.

Pervasive developmental disorder; not otherwise specified

These children show symptoms of autistic disorder and Asperger's disorder but don't fulfill all the conditions of both to be diagnosed with either.

Rett's disorder

This disorder was identified by Dr. Andreas Rett in 1966. Here the child has a normal development from first 6 months to 18 months and then it is followed by a developmental regression. They have autistic like symptoms. Apart from these they have other non autistic symptoms like microcephaly, gastrointestinal problems,, feeling and swallowing issues, severe intellectual functioning etc. There will be poor motor co-ordination and the symptoms may deteriorate after the age of 10. Unlike other developmental disorder, this is considered as a genetic disorder.

Childhood Disintegrative disorder

It is also known as Heller's syndrome. Here the symptoms are similar to autism but the onset is in a later stage and the symptoms are more extreme. Developmental regression may occur in language skills, social skills, self-care skills, control over bowel and bladder functions, play skills and motor skills.

33. Autism is a developmental disorder. Genetic, environmental and biological factors seem to have role in developing autism. Twin studies shows that identical twins are more affected than fraternal twins. This proves the role of genetic factors. Apart from genetic factors, certain biological factors also play a role in developing autism. Studies show that rubella in pregnant mother, fragile X syndrome, encephalitis and untreated PKU also cause autism.There are few studies that explain the role of parental neglect in developing autism. Since all the studies point to genetic and biological factors, parenting styles may have little role in this.

34. It had been hypothesized for several years that MMR vaccine ( Mumps, Measles and Rubella Vaccination leads to development of autism due to the mercury content in the vaccine. Now these vaccines don't contain mercury still some parents are concerned about whether vaccinations would cause autism. Taylor et al (2014)conducted a meta analysis and found out that there is no relationship between vaccination and autism spectrum disorders.

35. The parents are autistic children are given education about their conditions, symptoms and management. They are given physical therapies to deal with deficits in motor functioning. Early intervention focuses on developing social skills, langauge skills, cognitive skills and dealing with behavioural problems. These interventions can be done in home, schools and specialized centres for autism treatment. As there are individual differences among autistic children, the treatment plan should be highly individualized. Parents should also be provided with support groups to tackle with the stress of parenting an autistic child.

ABA (Applied Behaviour Analysis) is proved to be a successful intervention programme for autism. It mainly focuses on behaviour management. It used the principles of behaviour modification like shaping, chaining and reinforcement. Discrete trial learning involves breaking down a complex task into various simple tasks. The trainer helps the child to achieve everything one by one finally learning to the complex task. Pivotal response training uses positive reinforcers to shape behaviours. Picture Exchange communication system is used to develop communication skills in an autistic child. The treatment method for autism is always very comprehensive.

References

gerlach, E.K (2003). Autism Treatment Guide. Future Horizons.

Steiner, H. (2011). Handbook of Developmental Psychiatry. World Scientific

Taylor, L.E. Swerdfeger, M.L.Eslick, G.D (2014). Vaccines are not associated with Autism.: An evidence based Meta analysis of Case control and Cohort studies. Vaccine. 32 (9). 3623-3629. doi.org/10.1016/j.vaccine.2014.04.085